(1) For the purposes of
this section:
(a) "Affiliate" has the same meaning as in RCW 48.31B.005(1).
(b) "Claim" means a demand for monetary damages by a
claimant.
(c) "Claimant" means a person, including a decedent's
estate, who is seeking or has sought monetary damages for injury
or death caused by medical malpractice.
(d) "Tier" has the same meaning as in RCW 48.18.545(1)(h).
(e) "Underwrite" or "underwriting" means the process of
selecting, rejecting, or pricing a risk, and includes each of
these activities:
(i) Evaluation, selection, and classification of risk,
including placing a risk with an affiliate insurer that has
higher rates and/or rating plan components that will result in
higher premiums;
(ii) Application of classification plans, rates, rating
rules, and rating tiers to an insured risk; and
(iii) Determining eligibility for:
(A) Insurance coverage provisions;
(B) Higher policy limits; or
(C) Premium payment plans.
(2) During each underwriting process, an insurer may
consider the following factors only in combination with other
substantive underwriting factors:
(a) An insured has inquired about the nature or scope of
coverage under a medical malpractice insurance policy;
(b) An insured has notified their insurer about an incident
that may be covered under the terms of their medical malpractice
insurance policy, and that incident does not result in a claim;
or
(c) A claim made against an insured was closed by the
insurer without payment. An insurer may consider the effect of
multiple claims if they have a significant effect on the
insured's risk profile.
(3) If any underwriting activity related to the insured's
risk profile results in higher premiums as described under
subsection (1)(e)(i) and (ii) of this section or reduced coverage
as described under subsection (1)(e)(iii) of this section, the
insurer must provide written notice to the insured, in clear and
simple language, that describes the significant risk factors
which led to the underwriting action. The commissioner must
adopt rules that define the components of a risk profile that
require notice under this subsection.
[2006 c 8 § 211.]
NOTES:
Application -- 2006 c 8 §§ 211-213: "Sections 211, 212, and 213 of this act apply to insurance policies issued or renewed on or after January 1, 2007." [2006 c 8 § 403.]
Findings -- Intent -- Part headings and subheadings not law -- Severability -- 2006 c 8: See notes following RCW 5.64.010.